Characterizing a "Big Data" Cohort of Over 200,000 Low-Income US Infants and Children for Obesity Research: The ADVANCE Early Life Cohort
Characterizing a "Big Data" Cohort of Over 200,000 Low-Income US Infants and Children for Obesity Research: The ADVANCE Early Life Cohort
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DOI：
10.1007/s10995-016-2232-5
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发表时间：
2017-03-01
影响因子：
2.3
通讯作者：
DeVoe, J. E.
中科院分区：
文献类型：
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作者：
Boone-Heinonen, J.;Tillotson, C. J.;DeVoe, J. E.
前言低收入人群暴露于肥胖的早期生活风险因素增加，但在纵向研究中研究不足。我们的目标是评估从安全网诊所的电子健康记录数据中提取的队列在调查早期出现的肥胖方面的效用。方法我们检查了来自PCORnet高级临床数据研究网络的数据，这是一个由联邦合格的健康中心组成的全国性网络，为全美170万安全网患者提供服务。这一队列包括在2012-2014年间，在0-5岁时进行了有效体重指数测量的患者。我们根据在弱势群体中进行早期肥胖研究所需的因素来描述队列：社会人口多样性，基于世界卫生组织(2年)或疾病控制中心(AE2年)增长曲线的体重状况，以及数据纵向。结果这一队列包括216,473名儿童，他们的种族/民族是多样化的(例如，17.9%是黑人，45.4%是西班牙裔)。大多数人(56.9%)的家庭收入低于联邦贫困水平；32%的家庭收入低于联邦贫困水平的50%。在2岁儿童中，分别有7.6%和5.3%的儿童身长体重偏高和偏低。在2-5岁儿童中，分别有15.0%、12.7%和2.4%的儿童超重、肥胖和严重肥胖；5.3%的儿童体重不足。在研究期间，79.2%的儿童进行了AE2 BMI测量。在4-5岁儿童中，21.9%的儿童在2岁时进行了体重指数测量。讨论先进的早期生活队列提供了独特的机会，在研究不足的低收入和少数族裔儿童人群中调查肥胖的早期生活决定因素。
Introduction Low-income populations have elevated exposure to early life risk factors for obesity, but are understudied in longitudinal research. Our objective was to assess the utility of a cohort derived from electronic health record data from safety net clinics for investigation of obesity emerging in early life. Methods We examined data from the PCORNet ADVANCE Clinical Data Research Network, a national network of Federally-Qualified Health Centers serving > 1.7 million safety net patients across the US. This cohort includes patients who, in 2012-2014, had ae1 valid body mass index measure when they were 0-5 years of age. We characterized the cohort with respect to factors required for early life obesity research in vulnerable subgroups: sociodemographic diversity, weight status based on World Health Organization (< 2 years) or Centers for Disease Control (ae2 years) growth curves, and data longitudinality. Results The cohort includes 216,473 children and is racially/ethnically diverse (e.g., 17.9% Black, 45.4% Hispanic). A majority (56.9%) had family incomes below the Federal Poverty Level (FPL); 32% were < 50% of FPL. Among children < 2 years, 7.6 and 5.3% had high and low weight-for-length, respectively. Among children 2-5 years, 15.0, 12.7 and 2.4% were overweight, obese, and severely obese, respectively; 5.3% were underweight. In the study period, 79.2% of children had ae2 BMI measures. Among 4-5 year olds, 21.9% had > 1 BMI measure when they were < 2 years. Discussion The ADVANCE Early Life cohort offers unique opportunities to investigate early life determinants of obesity in the understudied population of low income and minority children.